Because of its tissue apposition capabilities and easy en face application, OTSC is used as a single therapy or as part of a multimodal combination approach to treat complex defects of the luminal gastrointestinal tract
Moenkemueller K et al., Department of Gastroenterology, Otto-von-Guericke University, Magdeburg, Germany, published an atlas of examples of challenging clinical situations treated with the OTSC, aiming to describe its use beyond traditional indications. Special emphasis is laid on key technical aspects and potential limitations of the device in the context of complex endoluminal gastrointestinal disorders.
Diagnostic pictorial material of complex clinical conditions, pictorials of the endoscopic view before, during and after therapy, graphics showing the steps of OTSC application, and a supplementary video provide an overview on the topic as well as detailed information on the different clinical pictures and therapeutic steps.
Topics treated in the publication include OTSC application for bleeding ulcers, located in difficult positions, for prophylaxis and management of perforations associated with endoscopic resection of submucosal tumors, for closure of complex gastrointestinal wall defects such as gastro-pleural and entero-enteric fistulas, for esophageal stent fixation, for acquisition of a full-thickness specimen for diagnostic purpose and many more.
The authors emphasize, that although using the OTSC clip is generally straightforward, it is essential that the therapeutic endoscopist has a clear understanding of the advantages and potential limitations of this device.
The Use of the Over the Scope Clips Beyond Its Standard Use: A Pictorial Description
Moenkemueller K, Martínez-Alcalá A, Schmidt AR, Kratt T.
Gastrointest Endoscopy Clin N Am 30 (2020) 41-74.